Comparative Analysis of Health Research Financing as a Veritable Tool for Achieving and Sustaining Universal Health Coverage in Nigeria and South Africa
Adeneye Adeniyi Kazeem,
Sulyman Medinat Ayobami,
Adeneye Adejuwon Adewale,
Olayemi Olalekan Moses,
Salami Kabiru Kunle
Issue:
Volume 6, Issue 4, December 2021
Pages:
100-117
Received:
4 May 2021
Accepted:
7 June 2021
Published:
12 October 2021
Abstract: Background: Nigeria is a signatory to the Abuja Declaration on allocation of 15% of the national budget to health and World Health Organization declarations that call on countries to allocate at least 2% of the national health expenditure to research. This review estimated the percentage share allocation of Nigeria’s national budget to health and health research. Method: This is a documentary review of the national budget and research literature on healthcare financing in Nigeria and South Africa, Africa’s largest economies. No date restrictions were placed on the searches except the special focus on the national treasury reports and annual institutional financial reports published between 2012 and 2018. We searched nine electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, Cochrane library, Academic Search Complete, Google and Google Scholar and HINARI) and, national treasury Databases of Nigeria and South Africa with search terms that included public health financing. Results: Nigeria’s total budget increased by 83% from N4.7 trillion (USD13.1 billion) in 2012 to N8.6 trillion (USD23.9 billion) with a corresponding 26% increase in health allocation and 55.4% growth in health research allocation between 2012 and 2018. In contrast, South Africa’s total budget increased by 57.5% from R1.06 trillion (USD74.3 billion) in 2012 to R1.67 trillion (USD117.1 billion) with a corresponding 68.4% increase in health allocation that fluctuated between R122 billion (USD8.6 billion) and R205.4 billion (USD14.4 billion) in the same period. The percentage increase in health research allocation for South Africa was 69.3% in the same period. While South Africa with near universal health coverage (UHC) allocated an average of 11.7% and 1.2% to health and health research respectively in 2012-2018, Nigeria allocated only an average of 5.0% and 0.74% to health and health research respectively in the same period with no trajectory towards achieving the 15% and 2% targets. Conclusions: Findings underscore very poor health sector and health research funding in Nigeria and still far from meeting the targets of international declarations in contrast to SA. Realizing the pivotal role of a strong health research base, substantial increase in health and health research budget allocations to meet the 15% and 2% targets respectively are required to achieve and sustain UHC and improved health outcomes in Nigeria by 2030.
Abstract: Background: Nigeria is a signatory to the Abuja Declaration on allocation of 15% of the national budget to health and World Health Organization declarations that call on countries to allocate at least 2% of the national health expenditure to research. This review estimated the percentage share allocation of Nigeria’s national budget to health and h...
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Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia
Temesgen Jaleta Dibaba,
Dufera Rikitu Terefa,
Biniam Worku Hailu
Issue:
Volume 6, Issue 4, December 2021
Pages:
118-126
Received:
30 November 2021
Accepted:
20 December 2021
Published:
29 December 2021
Abstract: Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based health insurance in the study area was scanty. Objective: This study aimed to assess willingness to join community based health insurance scheme and its predictors among informal Sectors in Buno Bedele zone, Southwest Ethiopia, 2021. Methods: A community-based cross-sectional study design was conducted on willingness to join community based health insurance and its predictors among informal sectors in Buno Bedele Zone, South west Ethiopia from January 01 to 30, 2021. Multistage simple random sampling was used to select 555 households. Data were collected using a semi-structured interviewer-administered pretested questionnaire. Data were entered into Epi-Data version 3.1 and analyzed with SPSS Version 25. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value <0.05 and AOR values with 95% CI. Finally, fitness of the model was checked by using Hosmer and Lemeshow goodness-of-fit test. Results: Of the sampled respondents, 543 participated in this study with response rate of 98.3%. Of these, 426 (78.5%) were willing to join the scheme. The study found that, educational status of who can read and write [AOR=3.96; 95% CI, 2.02, 7.75], family size > 5 [AOR=2.61; 95% CI, 1.45, 4.17], poor households [AOR=4.89; 95% CI, 2.79, 8.57], experience of an illnesses in the last three months [AOR=2.28; 95% CI, 1.21, 4.30], had information about CBHI [AOR=2.24; 95% CI, 1.18, 4.25] and participating in any indigenous community insurance [AOR=7.86; 95% CI, 4.47, 3.83] were significant predictors of willingness to join the scheme. Conclusion: The study revealed that more than three fourth of respondents were willing to join CBHI. Educational status of who can read and write, family size > 5, poor households, experience of an illnesses, had information about CBHI and participating in any indigenous community insurance were more likely to join the scheme. So, the government should strengthen efforts to scale up this scheme in the informal sectors specifically to areas not yet implemented, to reduce direct out-of-pocket payment at service delivery points. This will contribute to guarantee informal sectors access to quality health services without facing financial hardship, to achieve universal health coverage for all.
Abstract: Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based ...
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Determinants of Informal Competition Among Firms in Ethiopia
Issue:
Volume 6, Issue 4, December 2021
Pages:
127-132
Received:
12 December 2021
Accepted:
27 December 2021
Published:
31 December 2021
Abstract: The study investigated intensity of informal competition among firms in Ethiopia, using primary data source from the 2015 World Bank Enterprise Surveys for Ethiopia (Ethiopia - Enterprise Survey 2015). The estimated linear probability model (LPM) revealed that the probability prevalence (intensity) of informal competition among firms in Ethiopia is about 38.5%.It indicated that informality is a key problem in Ethiopia. The study also found that prevalence of highest corruption, burden of tax rate and credit access constraint are found to be positively and significantly affecting informal competition of firms in Ethiopia. On the contrary, firm size are found to be negatively and significantly affecting informal competition of firms. Correspondingly, the study revealed that regular inspection and communication of tax officials with firms could not contribute in reducing intensity of informality even if most studies indicated that increase in government enforcement on tax code lead to reduce informality. As many studies indicated that experience of top managers are contributing a lot for reducing informality in an establishment; however, this study exhibited that it does not save firms from informality in Ethiopia. In a nut shell, more research should be conducted as to why tax inspections and experience of top manager could not save firms from informality in Ethiopia.
Abstract: The study investigated intensity of informal competition among firms in Ethiopia, using primary data source from the 2015 World Bank Enterprise Surveys for Ethiopia (Ethiopia - Enterprise Survey 2015). The estimated linear probability model (LPM) revealed that the probability prevalence (intensity) of informal competition among firms in Ethiopia is...
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